biostudies-literatureUnknown87Huang R<h4>Background</h4>Metabolic dysfunction is associated with liver disease but it is unclear if it would impact responses to antiviral treatment in chronic hepatitis B (CHB) patients.<h4>Methods</h4>Using data from an international consortium of 4507 treatment-naïve CHB patients who initiated nucleos(t)ide analogues (NAs) between January 2004 and August 2024 from 32 centers and propensity-score matching (PSM) to balance the background of patients with and without metabolic disease (diabetes, obesity, dyslipidemia, or hypertension), we compared their biochemical (BR), virologic (VR), and complete (CR) response.<h4>Findings</h4>More than half (54.8%) had at least one metabolic disease. Patients with metabolic disease (vs. no) were older and more likely male. In the PSM cohort of 893 pairs of EClinicalMedicine103407https://www.ebi.ac.uk/biostudies/studies/S-EPMC12359161biostudies-literatureImpact of metabolic dysfunction on treatment responses to nucleos(t)ide analogues in chronic hepatitis B: a retrospective multi-center REAL-B cohort study.PMC12359161Ito THuang CFWu CEnomoto MTsuji KJung JHChuma MHuang RKim SEYu MLJun DWYasuda SYeh MLKim GAMaeda MTseng CHLi JJeong SWHsu YCTakaguchi KInoue KToyoda HItobayashi EAbe HAtsukawa MChuang WLDai CYNguyen MHOh HLiu JKUojima HGadano ASenoh TIshigami MHuang DQTanaka YCheung RYoon EItokawa NKozuka RTakahashi HAhn SBNozaki ATrinh HIshikawa TWatanabe TTsai PCChau AKawashima KVutien PHsiao TMarciano SHuang JFHonda TfalseImpact of metabolic dysfunction on treatment responses to nucleos(t)ide analogues in chronic hepatitis B: a retrospective multi-center REAL-B cohort study.<h4>Background</h4>Metabolic dysfunction is associated with liver disease but it is unclear if it would impact responses to antiviral treatment in chronic hepatitis B (CHB) patients.<h4>Methods</h4>Using data from an international consortium of 4507 treatment-naïve CHB patients who initiated nucleos(t)ide analogues (NAs) between January 2004 and August 2024 from 32 centers and propensity-score matching (PSM) to balance the background of patients with and without metabolic disease (diabetes, obesity, dyslipidemia, or hypertension), we compared their biochemical (BR), virologic (VR), and complete (CR) response.<h4>Findings</h4>More than half (54.8%) had at least one metabolic disease. Patients with metabolic disease (vs. no) were older and more likely male. In the PSM cohort of 893 pairs of 2025-01-01T00:00:00Z2025 Sep2026-05-02T03:49:49.997Z2026-04-07T17:36:14.834ZS-EPMC123591614083146510.1016/j.eclinm.2025.103407